MEDICARE: F AND M SPECIALTY PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467580993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	F AND M SPECIALTY PHARMACY INC

Provider Business Mailing Address
First Line	:	118 VILLAGE ST
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-5302
Country	:	US
Telephone Number	:	985-781-6798
Fax Number	:	985-781-9580

Provider Business Practice Location Address
First Line	:	118 VILLAGE ST
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-5302
Country	:	US
Telephone Number	:	985-781-6798
Fax Number	:	985-781-9580

Authorized Official
Title or Position	:	VICE-PRESIDENT
Name	:	MR. HENRY FOX SKELTON II
Credential	:	R.PH.
Telephone Number	:	601-939-9353

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	08/25/2008

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